PROJECT SUMMARY Urinary incontinence (UI) and functional dependence are prevalent and linked geriatric syndromes among community dwelling older women. Pelvic floor muscle exercises (PFME) were established to prevent and treat UI symptoms in young, post-partum women. Successful therapy is dependent on the presence of normal skeletal muscle health of the pelvic floor. Currently, PFME are the crux of non-surgical treatment of UI in older women. Functional and cognitive impairment and sarcopenia become more prevalent with aging. However, current PFME therapy has never evolved to consider these aging-associated anatomic and functional changes. Therefore, the impact of sarcopenia and functional or cognitive impairment on the efficacy of PFME is unexplored. We hypothesize that the presence of one or more of these aging-related conditions may negatively impact the efficacy of PFME to treat UI symptoms in older women. Through this proposed cohort study, we aim to characterize the impact functional impairment, sarcopenia, and cognitive impairment on the efficacy of a standardized PFME regimen to treat UI symptoms in community-dwelling older women. Our results may provide innovative data on the linked relationship between UI and functional and cognitive impairment. The role of sarcopenia in this relationship is novel, and may explain how UI and functional impairment are linked geriatric syndromes. The potential unveiling of deficiencies in PFME as the non-surgical therapy for UI in older women is our focus. We plan to use the data to refine non-surgical therapy for older women with UI by developing a synergistic exercise-based functional intervention targeting the pelvic floor as well as other areas of weakness identified through this proposed study. This innovative intervention may decrease UI episodes in older women with functional impairment and/or sarcopenia and administered to account for cognitive impairment. Our overarching goal is to improve the physical performance and UI symptoms through an effective non-surgical treatment option for UI symptoms. This in turn will significantly impact the daily function and lives of older incontinent women.